Permit C ITY OF TIGARD ELECTRICAL PERMIT
4 a4W I 4.
DEVELOPMENT SERVICES DATE ISSUED: 7/15/03
PERMIT #: ELC2003 -00428
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102CB -07300
SITE ADDRESS: 10400 SW PARK ST ZONING: R-3.5
SUBDIVISION: MLP97 -0019 CHILDREN'S VILLAGE
BLOCK:
•
LOT : 001 JURISDICTION: TIG
Project Description: Install 2 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
FERNANDO, ANIL NIHAL KANWAR + RT ELECTRIC
ANNE ELIZABETH 2110 NW ALOCLEK DR #611
17549 OAK MEADOW LN HILLSBORO, OR 97124
LAKE OSWEGO, OR 97034
Phone: Phone: 503 - 629 -0906
•
Reg #: LIC 150426
ELE 34 -585C
FEES SUP 4294S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 7/15/03 $53.50
[TAX] 8% State Tax 7/15/03 $4.28 Rough -
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the 0 on Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rul 'red questions to OUNC at (503)
246 -6699 or 1 -800- 32 -23 •/ . `
e[7 i
Issued By: ., _ - .„ / Permit Signature: k
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: 94 / S
Call 639 -4175 by 7:00pm for an inspection the next business day
Jul 15 03 07:53a RT Electric Co (503) 629 -0911 F.1
JUL -14 -03 07:02 PM JOHN KLUNE Co. 503 639 4359 P -01
Electrical Permit A !cation . . . . irt( i ; `t tiI e,�l.l
R E c
ReceivedReceivedElectrical i
attlev: 7 —/6 ` j Pernit No. r- a63;C) 3 -0/ /-
City 0� Tigard Paanina Approval Sip .
13125 SW Hatt Blvd- _7• Pmt
OUt'
P1s Review •
Tigard, Oregon 97223 JUL 15 20 ally: Permit No.: _•_
Phone: 503 -639 -4171 Fix: 503-59S-191Q_ Poat- Rcvicw Land Ilse
uctuntt: www.ci.tigarQor us CITY OF -.i. .•' I Contact Ariz.: I ® See Page •
fo
24 - hour Inspection Requ � : im D ' - - - - Name/Method: i Supplmmmasat ntormatlnn. -
, PE OF WORK . t ' PLAN REVIEW (Fleece cheek 'althea it )
New construction Demolition t Service over 275 amps- ❑ Hea /*.cats fecltity'
i ii
commercial ❑ hazardous location
Addition/alteration/r, placement Other: ❑ Service over X70 amps- ral;ng of ❑Building over 10,000 aquae feet,
CATEGOR :OF CONSTRUCTION .. - a
1 & 2 family dwellings four or mc rpideatiel units in f
• 1 & 2 - Tamil dwell - CommcrcialRndustrial ❑ System over G00 volts nominal one 'nurture 1
❑ Building over tires Works ❑ Feeders, 400 asps * man
MI ACCESSb >3uildia- MI6 Multi-Family _ ❑ occwpanl lmd o v e r 99 persona ❑ Merwttcwed nmutltres Of Rv lark
I. Master Budder a Other: D Ewan/lighting p>en ❑ Omer:
.'. ' 3O19SITE.INF• • TIONattd, •. ATION • Submit ofpiens with any of the Awl.
Job site address: s w . A ., S' T he strove sum sat a plisil le tote ra caoatrsd service.
Suite 11: • Bid • I • • t. #: Number or + • _ lost , er • ermit allowed
Pte oct Name.. .1NIFIr -
Deserl • ti es S Fee (mi. Tom 11
• Cross S7et 1rections !Ob Eite:
a err nI • attatamgk or men , per �
dwelling ems Whales attaetred garage.
� A F a- 4' !/ 7"D PA /�Ai service Included:
1000 • . a to lea 145.1
A/)wr - ' fl tD ' Z E. Bash additional 500 e • . ft. or • , 'on dace + 33 ]111111M111 i
Subdivision; Lot i#: Len's - - ., residential 11111kit:'>t 111 o
anneal n non home or r e
Tax ma � / � areal #: Each tnanufaemad name or modular dwetHng t
D ; - E]'r" 0 • s)iiiL) i 11 'ice'"? feeder
Serrtrcsor faders • lasulbttba.
; : - wow altered= w relxetbo: I
200 • a' • I 80.1' 2
t ' A re/h+R!!' frls•!d err 70 A A.? 201 to 400 a t1•t1/ :I MONO
v '' ✓ 4A A SS A4• 401 eenn.. to 400 ,., • 11MI t1E111=1•1111n
.' ::i:5 • • '' Mali i�lt -' •i. 601 .... to 100 MI 240 7
N��zn�'ae • u + + e ., or vafu 11111.•112=41111111113 toomarimammi
Address: alp yBD $ " Sr 'Temperary services orfeeders - ttutaltatloa, .
Ci 1StateJZi , : • ' 2 eor°± era:
66.E
Phone: . 0/31 Fax: :, ,_ to 400 • a loo. '. Q
MN 1111111Efa MUM la
CANT • • ` :; ■ Breach elrtstm •Dew, alteration, or
Name : =p Alva , g. a4. ••o&-• eater slop per panei:
A. Fee for branch circuits with purchase of
Address: Z D A O « . I ...A. vice or feeder - ach broach circuit '
8. Fee for ban&A elreutu without paeitaee or
ri a (setter iw uu • ranch chub Phone: , _ is. Each @coral brooch cirs:ait DM M 1111•111•11H
>�.malt: Ml ac (Sauces a tocdQ not io clutledf
• ; 1. « • Peeh . or • tm 421!°1° 13 AO =III
t `fs .• "° •` �i �' 1?aeh .' . of make li., , 2
Job No: • i t6'euit(a> err a an • • slangy pane ,
1e s Name: alters•• • orma 2
Business Mill.
Address: ..../. av _ a Da Di :
Lath addlttonaapestton one the allowable In • 'Afire
Cl /$t8tl°,/Zi I: t :. . .! -• /'>.' Pct in •-•■ •• • hvar tnln t hour)
Phone: 6 .9 09.e Fax: 6 -9 O 9 // Investioation for:
CCB Lic. #: --f • V tic. 1+ 4 S` -' :- ±`k ,. 7-f. G" '
Supenising electrician 4 / Subtotal S 7G
ail. ature re . uired: 1 i,/ � .:. -- Z — Plan Review k25% of Pcfntit Pee •
PrintNarne: ' -,y" • .-s . Lic. #: '' • �� State S . : 8% of Ported? Fee PM' _:
jr TOTAL PERMIT TEE arm , S 7 ,
AuthariLX) / Idedca This rents anoustuss eapren It • lamest b not tamed wkaln
Signature: Date: • /y 0) 110 days alter It has bass aesepted au complete.
• Tae methodology get by•ret-CeuatySulldingraduatr Service Board.
(Please print arm)
blpses1Peastit FarmskEICPeratitP?p.doc OI,v?
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Rees nested 1 O/2 340 AM PM BUP
Location /D V p /c S7 Suite MEC
Contact Person Ph ( <3 ) / 3 7 PLM
Contractor Ph ( ) 30,-99g? SWR
BUILDING Tenant/Owner ELC
Footing ELC DU r 2_e
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab -
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
T FAIL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Fin ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
?A ART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date /°4 Inspector i 4 IIJ .1 /•� Ext
Other:
Final DO NOT REMOVE this inspection racer from the ob site.
PASS PART FAIL